Development and validation of a radiomics nomogram for identifying invasiveness of pulmonary adenocarcinomas appearing as subcentimeter ground-glass opacity nodules

Abstract

The aim of the present study was to develop and validate a radiomics-based nomogram for differentiation of preinvasive lesions from invasive lesions that appearing as ground-glass opacity nodules (GGNs) ≤10 mm (subcentimeter) in diameter at CT. A total of 542 consecutive patients with 626 pathologically confirmed pulmonary subcentimeter GGNs were retrospectively studied from October 2011 to September 2017. All the GGNs were divided into a training set (n = 334) and a validation set (n = 292). Researchers extracted 475 radiomics features from the plain CT images; a radiomics signature was constructed with the least absolute shrinkage and selection operator (LASSO) based on multivariable regression in the training set. Based on the multivariable logistic regression model, a radiomics nomogram was developed in the training set. The performance of the nomogram was evaluated with respect to its calibration, discrimination, and clinical-utility and this was assessed in the validation set. The constructed radiomics signature, which consisted of 15 radiomics features, was significantly associated with the invasiveness of subcentimeter GGNs (P < 0.0001 for both training set and validation set). To build the nomogram model, radiomics signature and mean CT value were used. The nomogram model demonstrated good discrimination and calibration in both training set (C-index, 0.716 [95% CI, 0.632 to 0.801]) and validation set (C-index, 0.707 [95% CI, 0.625 to 0.788]). Decision curve analysis (DCA) indicated that radiomics-based nomogram was clinically useful. A radiomics-based nomogram that incorporates both radiomics signature and mean CT value is constructed in the study, which can be conveniently used to facilitate the preoperative individualized prediction of the invasiveness in patients with subcentimeter GGNs.

Invasiveness and surgical timing evaluation by clinical features of ground‐glass opacity nodules in lung cancers

“…In the study by Zhao et al . mean CT value was chosen for distinguishing the preinvasiveness from the invasiveness . We also found a similar result in our study that there was a correlation between the tumor volume and invasiveness.…”

“…26 In the study by Zhao et al mean CT value was chosen for distinguishing the preinvasiveness from the invasiveness. 27 We also found a similar result in our study that there was a correlation between the tumor volume and invasiveness. The mean CT value did not reveal the significant difference in the present study, despite the values being similar in comparison with the data in the study by Zhao et al However, maximal tumor attenuation was another significant factor for the invasiveness reported in our study and was compatible with the study by Li et al 28 Moreover, the mean attenuation of the solid component has been evaluated in a previous study and revealed a significant difference between preinvasiveness and invasiveness.…”

“…6 An irregular margin of the GGO nodules was positively associated with invasive lesions. 27 In our study, we did not find a correlation between the nodular margin and invasiveness, and we infer that the small size of the invasive group may be the major cause. Bubble lucency of the GGO nodule was chosen as the CT feature in a previous study to distinguish the IA from AIS/MIA, although the result revealed no significant difference.…”

“…The morphology between preinvasive nodules and invasive nodules has also been previously reported and the smooth margin noted, mainly in preinvasive lesions . An irregular margin of the GGO nodules was positively associated with invasive lesions . In our study, we did not find a correlation between the nodular margin and invasiveness, and we infer that the small size of the invasive group may be the major cause.…”

Re-profiling of drugs in radiological pharmacology: N-acetylcysteine

“…В її основі -тривалі (2000-2011 рр.) клінічно апробовані міжнародні експертні дослідження (International association for the study of lung cancer/Аmerican thoracic society/Еuropean respiratory society) пульмонологів, морфологів, радіологів, молекулярних біологів, торакальних хірургів [30,31]. Авторський колектив (понад 50 фахівців) ретельно вивчив більш ніж 500 тематичних публікацій, розробив методологічні засади нової класифікації й довів її до остаточної редакції через запровадження у ряді відомих й авторитетних клінік.…”